Ray N F, Thamer M, Fadillioglu B, Gergen P J
Medical Technology and Practice Patterns Institute, Washington, DC, USA.
Chest. 1998 May;113(5):1277-84. doi: 10.1378/chest.113.5.1277.
To explicate the interrelationship between asthma hospitalization and race/ethnicity and income.
Small area ecologic analysis using census and administrative data.
All asthma hospitalizations in California were identified using the 1993 California Hospital Discharge file. Small area analyses of Los Angeles (LA) were compared with published rates in New York City (NYC).
In 1993, the age-adjusted asthma hospitalization rate in California for nonelderly blacks was 42.5/10,000-approximately four times higher than other populations. Black rates remained fourfold higher after stratification by age, income, and urbanicity. Multivariate analyses suggest that the association between black race and asthma hospitalization is independent of income. Regardless of race, children and persons living in poverty were at increased risk for asthma hospitalization. Urbanicity was not a predictor for asthma hospitalization. Overall, asthma hospitalization rates in NYC were 2.8 times higher compared with rates in LA; while rates were similar among blacks (60 vs 40/10,000, respectively), Puerto Rican Hispanics in NYC had dramatically higher rates compared with Mexican Hispanics in LA (63 vs 14/10,000, respectively).
After controlling for socioeconomic status, notable differences in asthma hospitalization by race and ethnicity persist. The reasons for the significantly elevated risk of asthma morbidity among blacks remain unclear.
阐明哮喘住院治疗与种族/族裔及收入之间的相互关系。
利用人口普查和行政数据进行小区域生态分析。
使用1993年加利福尼亚州医院出院档案确定该州所有哮喘住院病例。将洛杉矶的小区域分析结果与纽约市公布的发病率进行比较。
1993年，加利福尼亚州非老年黑人经年龄调整后的哮喘住院率为42.5/10000，约为其他人群的四倍。按年龄、收入和城市化程度分层后，黑人的发病率仍高出四倍。多变量分析表明，黑人种族与哮喘住院之间的关联独立于收入。无论种族如何，儿童和生活贫困者哮喘住院风险增加。城市化程度并非哮喘住院的预测因素。总体而言，纽约市的哮喘住院率是洛杉矶的2.8倍；虽然黑人群体的发病率相似（分别为60/10000和40/10000），但纽约市的波多黎各裔西班牙裔发病率显著高于洛杉矶的墨西哥裔西班牙裔（分别为63/10000和14/10000）。
在控制社会经济地位后，按种族和族裔划分的哮喘住院率仍存在显著差异。黑人哮喘发病率显著升高的原因尚不清楚。
